What causes earwax build-up and when to seek removal
Earwax (known medically as cerumen) is a natural substance produced by glands in the ear canal. Though it might seem unpleasant, it actually plays an important role in keeping your ears healthy. Earwax protects the delicate inner workings of the ear by trapping dust, bacteria, and other particles, preventing them from reaching deeper into the ear. It also has lubricating properties, helping to prevent the skin inside the ear from becoming dry and itchy.
Most of the time, earwax works its way out of the ear naturally, without any need for intervention. However, in some cases, it can build up and cause a blockage. When this happens, it may lead to discomfort, hearing problems, or even infections. Let’s take a closer look at why this build-up occurs and when you should seek help to have it removed.
Why does earwax build up?
There are several reasons why ear wax may accumulate or become impacted:
1) Natural variations in wax production
Some people simply produce more earwax than others. Just as some individuals have oily skin and others have dry skin, earwax production varies from person to person. If your glands are more active, or your wax is particularly thick or dry, you may be more prone to build-up.
2) Narrow or hairy ear canals
The shape and size of your ear canal can also influence wax build-up. Narrow ear canals or those with more hair can make it harder for wax to work its way out naturally. This can cause wax to become trapped and gradually accumulate.
3) Using cotton buds or inserting objects into the ear
One of the most common causes of earwax problems is using cotton buds (or other objects like hairpins or earbuds) to clean the ears. While it might feel like you're removing wax, you're often just pushing it further into the ear canal, where it becomes compacted and harder to remove.
4) Wearing hearing aids or earplugs regularly
Devices such as earplugs, or in-ear headphones can interfere with the natural movement of wax out of the ear. They may also stimulate the glands to produce more wax than usual, leading to build-up over time.
5) Ageing
As we age, the composition of our ear wax can change. It may become drier, which makes it harder for the wax to move out of the ear canal. Older adults are therefore more likely to experience impacted wax and related symptoms.
6) Skin conditions or infections
Certain skin conditions like eczema or psoriasis, or previous infections in the ear, can affect the way wax is produced and removed. They can cause the skin in the ear canal to flake more than usual, mixing with wax and creating blockages.
Symptoms of earwax build-up
While a small amount of ear wax is perfectly normal, excessive build-up can cause a range of symptoms, including:
A feeling of fullness or blockage in the ear
Decreased or muffled hearing
Itchiness or irritation inside the ear
Tinnitus (ringing or buzzing sounds)
Dizziness or imbalance
Earache or discomfort
In more severe cases, impacted earwax can lead to infections, with symptoms such as pain, discharge, and even fever.
When to seek earwax removal
Not all earwax requires removal – in many cases, it will take care of itself. But there are times when professional help is needed. You should consider seeing a healthcare professional if:
You’re experiencing any of the symptoms listed above
Your hearing is noticeably affected
You’ve tried over-the-counter remedies with no success
You’ve had problems with wax build-up in the past
Importantly, if you have diabetes, a weakened immune system, a history of ear surgery, or a perforated eardrum, you should always seek medical advice before attempting any earwax removal.
How is earwax removed?
There are several safe methods professionals use to remove ear wax:
1) Microsuction
This is one of the most common and effective methods. A small suction device is used to gently remove the wax under the guidance of a microscope. It’s quick, usually painless, and doesn’t involve water, making it suitable for people with certain ear conditions.
2) Irrigation
Ear irrigation involves using a controlled stream of warm water to flush out the wax. It’s a modern and safer version of the old ‘syringing’ technique. This method is generally effective but may not be suitable for everyone, especially those with a history of ear infections or perforated eardrums.
3) Manual removal
Sometimes, wax is removed manually using special instruments such as a curette. This is usually done under visual guidance using a headlight or microscope to ensure safety.
What you should avoid
Don’t use cotton buds. They often do more harm than good.
Avoid ear candles. There is no scientific evidence that they work, and they carry a risk of burns or injury.
Don’t attempt DIY removal with sharp objects. This can damage the ear canal or eardrum.
Prevention tips
To reduce the likelihood of earwax build-up:
Avoid inserting anything into your ears
Use olive oil aural spray occasionally if you are prone to dry or impacted wax (check with an audiologist or pharmacist or GP first)
Have regular check-ups if you are prone to wax issues
Earwax is a natural and necessary substance that usually takes care of itself. However, if it builds up and starts causing symptoms, it's best to seek professional help rather than trying to remove it yourself. Safe and effective treatments are widely available, and a professional can also advise on how to prevent future problems.
